Saturday, May 30, 2009

Navigating the 3 C's: Cancer, Causality & Conspiracy

Monday 18 MayMy Desk, the Atlantic on the left of me

Before I’d left the hospital I had first a visit from my neurosurgeon, Dr White, and then a day or two later from my Oncologist, Dr Eedes, to discuss first the histology and then the proposed treatment. The histology showed what Dr White had expected, a malignant tumour which, due to it’s position, he was able to remove in it’s entirety. However the tumour was like a beehive, he explained. You can see the beehive and remove it, but you don’t know how many bees are outside of the hive at any given time. These ‘bees’ of course being other cancerous cells in the surrounding tissues which are doing the cancer thing, namely reproducing, making more cancer cells. So the focus Dr White explained was to kill any remaining cancer cells. Enter Dr Eedes.

Dr Eedes, one of the most highly regarded Oncologists in the Western Cape, explained that for this particular type of brain cancer there was a ‘best practice’ used worldwide which involved six weeks of radiation combined with an oral chemo drug. He explained and I’ve also found out since that this particular form of chemo is on the milder side of possible chemo treatments, being oral and in slightly lighter doses than what other types of cancer often warrant.

So that was that sorted then?

It took me almost a week at home before I dared to go online in search of ‘more info’. There was a part of me that didn’t want to get too familiar with how the doctors saw me or my condition. I can appreciate how useful the labels are for them in helping them navigate what must be a very difficult landscape. I say ‘difficult’ because I did start to research and find out more about cancer in general and brain cancer in particular. The more I read I started to wonder how a person who becomes an Oncologist to ‘heal’ people with cancer must function with such a limited tool set (Radiation & Chemo) which has a very chequered history and jury’s still out on whether they actual heal.

Why was I so reluctant to engage with the clinical in’s and out’s of my condition? On the one hand I was weary and cautious not to be drawn into a set of labels that were just that, useful to describe something, but not the thing itself. On the other hand I really did not want to hear what the statistics were on my kind of cancer and the survival rates. Would you? But like all things you resist, viola! A friend with the best intentions sends me a link to a site that he thinks has useful info and within seconds of landing there I see a graph with survival rates for people with my kind of brain cancer. Reminds me of a Jedi mind trick: “What I don’t want you to think about is a jedi knight wearing a tutu”. Too late, right. So what did that change, if anything?

I now had a sense of why some people were so alarmed at my news. When I checked in with myself I also realised that these graphs were only one side of a much bigger story and so I started to read and research. Little did I know that I was about to uncover one of the biggest unanswered questions of our modern age.

The easy questions seem to be, in no particular order:

When will the aliens give us 3D TV technology?

Is there a God?

Who shot JFK?

Much harder I discovered was:

What causes cancer?

One of the first distinctions I discovered was that the combination of Surgery, radiation and chemo therapy does not technically heal the body of cancer as much as it removes the manifestation of cancer, namely the tumour. To heal the body of cancer something else often needs to happen, something that addresses the underlying cause, what gave rise to the cancer in the first place. But nobody can agree on what causes cancer! So where does that leave us, where does that leave me?

After all the reading it left me feeling between a rock and a very hard place. On the one hand I had great doctors prescribing six weeks of radiation and chemo therapy and on the other I had an avalanche of “alternative therapies” all vying for pole position. Not only did the alternative therapies demand their moment in the sun, their advocates also spent a huge amount of energy painting the “Big 3” (Surgery, Radiation & Chemo) as an evil triumvirate cooked up by a cabal comprised of the American Food and Drug Administration (FDA) and “Big Pharma”, intent on keeping their monopoly on ‘approved’ cancer treatments that they can profit on and squashing any treatment that they couldn’t own even if it did show promise or even heal people.

So how did I navigate this?

Intellectually I couldn’t resolve this. It was a minefield with both sides taking great pains to paint the other side negatively. What really set my alarm bells ringing was noticing how much energy going into making it a black and white issue. So I took the 3rd way. I felt my way through it is what I did.

I remember going to the Vincent Pallotti Oncology ward to have my mask made a week before my therapy started. I met the team that would treat me for the six weeks in the Radiography department as well as the team that would handle the chemotherapy. These are some of the best people I’ve met in a long time. I came away from that day feeling that I could go far with these people. I could feel that they cared and that they were committed to me healing. That decided it for me. I exhaled and knew that no ill could befall me in that place.

Ironically the harder part of the journey now is to navigate the myriad of alternative therapies. It seems there are enough alternative therapies to suit every kind of personality, eye colour and taste.